1. Andrew De Saro, EMT-B, BS, DC, DICCP, PhC(hon)
HIV and AIDS
Andrew De Saro, EMT-B, BS, DC, DICCP, PhC(hon)

2. safety & Awareness OPIM’s PPE
All Fluids are infectious until proven otherwise
Be mindful of your surrounding

3. Routes of transmission
Contact – most common
Direct - indirect
Droplet – coughing, talking, sneezing
Air – small particulates (TB or Varicella)
Food – Salmonella, E. coli, Listeria
Vector – fleas, mosquitoes, birds, & rodents

4. Airborne pathogens Influenza SARS Tuberculosis Meningitis Pertussis
1-3 days incubation
approx 3-10 days
Swine & Avian
Tuberculosis
6 weeks to show positive
Meningitis
2-10 days
Pertussis
avg 9-10 days (6-20)

5. Airborne pathogens Measles Mumps Rubella Varicella avg 14 days (7-21)
14-25 day range
Rubella
avg 14 days (12-23)
Varicella
2-3 weeks

6. Blood Borne Pathogens
Hepatitis – A, B, & C
HIV

7. What is HIV?
Retrovirus Incapable of Reproduction HIV to AIDS Controversy HIV vs AIDS

9. HIV History 1st HIV case 1959 1st US HIV case 1981 (CDC)
1st Time CDC uses AIDS 1982
1st FDA Approved Home Test 2002
2016:
36.7 mill have HIV worldwide
1 mill AIDS-related Illness Deaths
2017:
20.9 mill getting antiretroviral therapy (AZT or HAART)

10. Transmission Sexual Intercourse with infected partner
Pregnancy, Childbirth, & Breastfeeding
Sharing Needles with infected persons

11. How HIV is NOT Transmitted
Through the Air – coughing or sneezing
Living with an Infected Person
Through Food or Water
Sharing Clothes or Shaking Hands
Through Sweat or Tears
Sharing Toilets and Bathrooms
Sharing Cups, Plates, or Utensils
Vectors – mosquitoes, fleas or other insects
Touching, Hugging, or Kissing      
   

12. Signs and Symptoms Fatigue Night Sweats Sudden Weight Loss
Reoccurring Infections
Cancer

13. Clinical Findings Endocrinologic Manifestations Skin Manifestations
Gynecologic Manifestations
HIV-Related Malignancies
Kaposi’s sarcoma
non-Hodgkin’s lymphoma
Primary Brain lymphoma
Invasive cervical carcinoma

15. Differential Diagnosis
Essentials of Diagnosis
Risk Factors
Systemic Complaints
Opportunistic Infections
Aggressive cancers
Neurologic manifestations

16. Confirmation of HIV Infection
Positive HIV Test
Repeatedly positive ELISA – 2 or more
Western Blot  the final confirmation
Positive days after HIV infection
most within 3-4 weeks
Symptom onset usually 2-3 weeks for 80-90% of infected patients.
Monitor CD4+ & HIV RNA assay
(standard viral load test)

17. Pathogenesis 3 phases Primary (Acute) Phase Latent Phase Chronic Phase
Early HIV infection
Intermediate HIV infection
Chronic Phase
Late HIV infection
AIDs
CD4+ T cells drop below 200 cells per µL

18. Pathophysiology Immediate Th1 and Th2 response Autoimmunity
Immunodeficiency
Neurological Dysfunction

19. Documentation Incident Report Testing Period
Employee file concerning exposure
Record Keeping
Worker Comp.
Counseling

20. Something else to think about:
"Have you more faith in a spoonful of medicine than in the power that animates the living world?"
BJ Palmer